blog series: COVID-19 Response
Pediatric Health
Dear Friends of ICS:

As COVID-19 case numbers grow in the United States, doctors and researchers are learning more about how the virus impacts children and how treatment may differ from adults. While mitigating the impact of this virus on families and children is a crucial priority, doctors and families also face the regular daily medical concerns of young children: what about health care to make sure your child stays healthy?

The recommended schedule calls for 11 well-child visits in the first 30 months of life, followed by annual check-ins after that. Without knowing how long this crisis will continue, families may not be sure how to manage these visits. American Academy of Pediatrics (AAP) guidance “strongly supports the provision of well child care consistent…In the midst of the COVID-19 pandemic, the benefit of attending a well visit and receiving necessary immunizations and screenings should be balanced with the risk of exposure….”

However, most practices are not just operating as “business as usual.” Both the American AAP and the American Academy of Family Physicians ( AAFP ) have issued considerations for ensuring safety and hygiene during these visits to providers to consider. If you are a parent whose child needs pediatric care in coming weeks, consider asking your office what precautions they are taking, and be prepared to possibly see the following:

These include:
  • No more walk-in visits
  • Restricting well visits to those who need it most urgently – newborns, infants, and younger children who are scheduled for immunization, while rescheduling annual physical for older children for a later date.
  • Scheduling the morning for well visits and afternoons for sick visits
  • Designating specific rooms for “sick” and “well” visits; any clinical staff are in a “high risk” group, they should be focused on well visits only.
  • Increasing the frequency of cleaning and disinfecting beyond usual.
  • Removing all toys and activities from the waiting room.
  • Limiting attendees to the visit to only one parent/guardian – no additional adult or sibling
  • Enabling families to complete any paperwork or payment documents in advance (physical mail or online portal) or after the visit to reduce amount of time in the waiting room
  • Allow patients to “check in” and wait from the car if parking is available rather than in a waiting room.
  • Consider shifting visits to telehealth possible.

That last recommendation might surprise you if you’ve ever argued with young children over limits on their screen time! But the current crisis in American health care caused by the spread of COVID-19 is bringing the world of telehealth to many parents in a new way and demonstrating the value of this new horizon. One family medical provider explained that the shift to telemedicine had “moderate” challenges in getting patients used to it, but that overall it has given patients and staff alike “confidence and comfort.”

What about those medical needs you can’t reschedule? Kids don’t stop getting injured just because there is a crisis and, in fact, some experts worry that the current status of kids at home while parents try to work and homeschool may create more opportunities for hijinks which lead to injury. In a recent New York Times piece, a parenting writer details her own family’s experience with a pediatric emergency during the pandemic based on how experts recommend responding:

“If your child does get hurt, first tend to the wound and then call your child’s pediatrician — or, better yet, set up a telemedicine appointment. Your child’s doctor will not only help you assess whether you need in-person care but can also advise you on where to go. Pediatric facilities are often better than general emergency rooms or urgent cares, because they’re fairly empty and often free of coronavirus patients….

If you do end up in an emergency room, rest assured that most hospitals are following procedures to keep patients safe and protected from exposure to the new coronavirus. The Centers for Disease Control and Prevention have  advised  all U.S. hospitals and health care facilities to separate patients who have respiratory symptoms from those who don’t.”

Of course, telemedicine is not a cure-all and we need to think seriously about who gets left out of these advances. As the widespread closure of classrooms has reminded us, the “digital divide” is still very real, and children without technology access for online learning may also not be able to access digital medicine. A major article in The Washington Post highlighted these sharp challenges, reporting that more than 21 million Americans don’t have access to high-speed internet despite significant large investments by government over recent years - disproportionately low-income families and people of color. If your family, or families you work with, are struggling to secure necessary internet access during this time of isolation, the FCC maintains a list of internet providers who have taken their “Keep Americans Connected” pledge – consider starting there to find opportunities in your area.

Many American families were already uninsured or under-insured before this crisis, and a wave of layoffs as a result of the crisis may have caused many more to lose private health insurance. The federal Families First Coronavirus Response Act had a number of provisions related to Medicaid and Child Health Insurance Program (CHIP) services and eligibility; those working with families may find this explained from the Center for Children and Families helpful. These programs are administered by each individual state – you can start here to learn more about the opportunities in your own state.

Avoiding “non-essential” procedures and medical appointments is a key component of the national effort to slow the spread of the disease, through reducing crowded waiting rooms and conserving supplies for essential COVID-19 treatment. However, this does not mean all routine health needs should be placed on pause! The expert recommendations we’ve shared today can help keeps safe and healthy through this rapidly changing situation.

ICS works on behalf of children from prenatal to age 8.
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The Institute for Child Success is
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The Institute for Child Success is fueled by the BlueCross BlueShield of South Carolina Foundation, the Mary Black Foundation, and BlueCross BlueShield of South Carolina, an independent licensee of the BlueCross and BlueShield Association.